I am worried-my unvaxed 2 yr old stepped on a thorn-tetanas worry?

[kfillmore]

My two year old stepped on a thorn. It was imbedded a bit because I sort of saw her pull it out. I rinsed with ocean water and squeezed it and it bled. It is a very small cut. I don't think the thorn (which was on the beach, from washing up) was long, less than a 1/2 cm, probably 1/4 cm. Should I be worried? Should I call our Dr?

[chambom]

I want to give this a bump for you so hopefully someone really knowledgable responds.

Here is what information I have learned...tetanus cannot live with exposure to oxygen, so the "rusty nail" has to come up out of the ground and the rust can also hide the tetanus.  The wound has to not bleed.

I would think that there is no way a thorn had tetanus on it and if you got it to bleed that is good.

[Mirzam]

A worry for me? Absolutely not, I wouldn't have given tetanus a millisecond of a thought. I certainly wouldn't subject myself to the fear mongering of a medical doctor, over a thorn in the foot. It bled, your child is young and healthy, I don't see much of a tetanus risk there. JMO.

[MsFortune]

I'm pretty pro-vax, and no, I would not worry about this as a risk for tetanus.  Tetanus is pretty specific to where it lives / grows.  Like metal.  

[kfillmore]

Thanks!!

[Toolip]

pretty sure it's a myth that is grows on metal...

[Ella Enchanted]

It's absolutely a myth that tetanus grows on metal.  It's a bacteria that needs an environment without oxygen to grow.  The human body has a lot of oxygen.  If you've got good blood flow, your chance of getting tetanus is even slimmer.  And you know the best preventative?  Washing wounds thoroughly.  The importance of good sanitation is downplayed so much in favor of vaccines for everything.  

[AboutPediatrics]

Originally Posted by Toolip 

pretty sure it's a myth that is grows on metal...

Dormant tetanus spores from the soil can contaminate metal, splinters, thorns, etc., which can then get into a wound when you step on them or cut yourself with them. So tetanus doesn't grow on the metal, but the tetanus spores can be on the metal.

In some wounds, especially puncture wounds, the spores then release bacteria and grow, causing tetanus (lockjaw).

Can you wash them out? It likely depends on how deep the wound is. Nails and wires (like barb wire) are probably so good at causing tetanus because they don't leave much of a wound behind to clean.

FYI, rust on a nail has nothing to do with tetanus growing on it. If a nail is rusty, it may be older and be more likely to have tetanus spores on it, but you can get tetanus from a clean looking nail too.

Tetanus is rare in the US, although there are still cases. Here is a report that documents some cases in un-vaxed kids:

Philosophic Objection to Vaccination as a Risk for Tetanus Among Children Younger Than 15 Years
PEDIATRICS Vol. 109 No. 1 January 2002, pp. e2

Conclusion. The majority of recent cases of tetanus among children in the United States were in unvaccinated children whose parents objected to vaccination.

The study described 15 cases, including 2 newborns who got tetanus on their umbilical stump (mom not vaccinated), and others who got it from:

• a bug bite on their leg
• stepping on a wire in a barn
• stepping on a thorn
• stepping on a stick
• puncture and abrasion on hand/foot
• kicked tree stump in yard
• splinter on bare foot
• stepped on a nail in a barn
• had concrete fall on elbow
• cut finger at home

Two kids who had been vaccinated and got tetanus (older teens) had much milder illnesses than the other kids.

[TonyaW]

However in the study mentioned, they do not indicate how big the offending object was that caused the wound or how the wound was managed. Also, many of those children were Amish. They weren't likely to seek any medical care until the child was showing symptoms of tetanus. Finally, there is no diagnostic test to prove that a person has tetanus. The bug bite has always been questionable in my mind...what if that child had a serious reaction to the bug bite.

Anyway, the splinter or thorn which caused tetanus in the mentioned study could have been very, very large. For instance, there was a tree growing in my back yard with 2 inch thorns.

So, if my child stepped on a thorn, yes I would worry because that is how I am. I worry about tetanus which is so incredibly rare and unlikely to occur in children but I worry about the vaccine equally as much and do question its effectiveness because there are plenty of fully vaccinated people who have contracted tetatnus too.

BTW, the study that the previous poster mentioned took place over 15 years (I think) and none of the cases were fatal. So if you think about it and do not include the newborns, then that would amount to 1 or less unvaccinated child contracting tetanus per year and 2 which contracted tetanus were vaccinated. Those are very slim statistics and likely the wounds were improperly managed resulting from very large puncture wounds or crush wounds which are difficult to manage.

I would clean the wound well, soak the wound twice a day and give ledum and extra vitamin C for any puncture wound.

Edited by TonyaW - 3/9/11 at 2:17pm

[MountainMamaGC]

I would not worry about that wound. In the event my daughter had a wound to worry about, I would get her an injection of antibiotics. The wound would have to be pretty serious, like a dirty crush injury, or stepping on a dirty nail/or other nasty injury at a farm with lots of fecal matter around.

Anything on the surface would be made to bleed and cleaned with hydrogen peroxide.

[Magali]

Originally Posted by kfillmore 

My two year old stepped on a thorn. It was imbedded a bit because I sort of saw her pull it out. I rinsed with ocean water and squeezed it and it bled. It is a very small cut. I don't think the thorn (which was on the beach, from washing up) was long, less than a 1/2 cm, probably 1/4 cm. Should I be worried? Should I call our Dr?

Wouldn't worry about tetanus in this case at all. 

[AboutPediatrics]

Originally Posted by TonyaW 

BTW, the study that the previous poster mentioned took place over 15 years (I think) and none of the cases were fatal. So if you think about it and do not include the newborns, then that would amount to 1 or less unvaccinated child contracting tetanus per year and 2 which contracted tetanus were vaccinated. Those are very slim statistics and likely the wounds were improperly managed resulting from very large puncture wounds or crush wounds which are difficult to manage.

The study was over 8 years - from 1992 through 2000, during which there were 386 cases of tetanus in the US, including these cases in children < 15. The report doesn't mention anything about them being Amish.

Although there were no deaths, the report states that 'Eight children (53%) required mechanical ventilation. The median length of hospitalization was 24 days...'

My post was not meant to imply that there was a high risk from this sort of wound, but merely to point out that the risk is not zero, and that you can get tetanus from stepping on a thorn.

Also, the study states that 'Our cases likely constitute an underestimate of the actual number of tetanus cases in children during the study period,' as 'not all cases are recognized or reported.'